Bed Bug

1. Background
   1. Transmission into home
      1. Travel items (Luggage, Clothing, Shoes)
      2. Conduits (e.g. electrical wiring between rooms or attached apartments)
   2. Killing Bed Bugs
      1. Heat to over 120 F for at least 30 minutes
      2. Can withstand cold temperatures
      3. Can withstand not eating for up to one year
      4. Can withstand fogging devices
   3. Life stages
      1. Egg
         1. Adheres to surfaces via a glue-like substance
      2. Nymph (5 distinct stages)
         1. Size of sesame seed
      3. Adult
         1. Size of lentil
   4. Sites
      1. See Transmission into home as listed above
      2. Mattress or box spring seams and underside
      3. Wheel chairs
2. Symptoms
   1. Moderate to severe Pruritus
3. Signs: Bite Reaction
   1. Reaction is allergic and occurs in 70% of patients
   2. Bites form linear pattern (may form line of 3 bite sites)
   3. Distribution of bite sites on exposed skin
      1. Face and and neck
      2. Arms and legs
      3. Back
4. Prevention
   1. Identify infestations early
      1. Easier to eradicate at an earlier stage (prior to infestation of wiring)
   2. Quarentine items suspected of infestation
      1. Place items in sealable plastic bags
   3. Eradicate Bed Bugs
      1. See Killing Bed Bugs above
      2. Consider hand held steamer in commercial settings
      3. Consider dogs that have been trained to specifically smell for Bed Bugs
5. References
   1. Weigart and Jones in Majoewsky 2012) EM:RAP 12(4): 2-3